Table 3.
Summary of findings table
| Outcomes | Anticipated absolute effects* (95% CI) |
Relative effect (95% CI) |
No. of participants (studies) |
Quality of the evidence (GRADE) |
|
| Risk with placebo | Risk with CHM | ||||
| Comparison 1: CHM versus placebo | |||||
| Albuminuria follow- up: range 2–12 months | – | SMD 0.92 lower (1.35 lower to 0.51 lower) |
– | 1021 (8 RCTs) | ⨁⨁⨁◯MODERATE†‡ |
| 24 hours proteinuria follow-up: range 2–3 months | – | SMD 1.34 lower (2.18 lower to 0.51 lower) |
– | 699 (4 RCTs) | ⨁⨁◯◯LOW†‡§ |
| Scr follow-up: range 3–6 months | The mean Scr was 77.41 μmol/L | The mean Scr in the intervention group was 5.75 μmol/L higher (2.06 lower to 13.57 higher) |
– | 85 (2 RCTs) | ⨁⨁⨁◯MODERATE†¶ |
| eGFR follow-up: mean 3 months | The mean eGFR was 96.24 mL/min | The mean eGFR in the intervention group was 10.71 mL/min lower (23.93 lower to 2.51 higher) |
– | 44 (1 RCT) | ⨁⨁◯◯LOW†¶ |
| Comparison 2: placebo+ACEi/ ARB versus CHM+ACEi/ARB | |||||
| Albuminuria follow-up: range 3–6 months | – | SMD 0.56 lower (1.04 lower to 0.08 lower) | – | 330 (3 RCTs) | ⨁⨁⨁◯MODERATE¶** |
| 24 hours proteinuria follow-up: range 3–6 months | – | SMD 0.15 lower (0.52 lower to 0.23 higher) |
– | 489 (4 RCTs) | ⨁⨁◯◯LOW‡¶** |
| Scr follow-up: range 3–6 months | The mean Scr was 88.13 μmol/L | The mean Scr in the intervention group was 4.02 μmol/L lower (7.81 lower to 0.23 lower) |
– | 595 (5 RCTs) | ⨁⨁⨁◯MODERATE†§ |
| eGFR follow-up: range 3–6 months | The mean eGFR was 79.27 mL/min | The mean eGFR in the intervention group was 6.28 mL/min higher (2.42 higher to 10.14 higher) |
– | 535 (4 RCTs) | ⨁⨁⨁◯MODERATE§** |
| Comparison 3: CHM versus placebo + ACEi/ ARB | |||||
| All-cause mortality follow-up: mean 24 months | 0 per 1000 | 0 per 1000 (0 to 0) |
not estimable | 315 (1 RCT) | ⨁⨁⨁◯ MODERATE†† |
| Composite end-points events follow-up: mean 24 months | 133 per 1000 | 45 per 1000 (20 to 102) |
RR 0.34 (0.15 to 0.77) |
315 (1 RCT) | ⨁⨁◯◯ LOW¶‡‡ |
| Albuminuria follow-up: mean 3 months | – | SMD 6.38 lower (9.01 lower to 3.75 lower) |
– | 499 (3 RCTs) | ⨁◯◯◯VERY LOW†‡¶ |
| 24 hours proteinuria follow-up: range 1–3 months | – | SMD 0.00 lower (0.32 lower to 0.32 higher) |
– | 260 (2 RCTs) | ⨁⨁⨁◯ LOW¶§ § |
| Scr follow-up: range 1–3 months | The mean Scr was 105.52 μmol/L | The mean Scr in the intervention group was 4.05 μmol/L lower (6.09 lower to 2.01 lower) |
– | 590 (4 RCTs) | ⨁⨁⨁◯ MODERATE †§‡ |
| eGFR follow-up: range 1–3 months | The mean eGFR was 97.24 mL/min | The mean eGFR in the intervention group was 0.57 mL/min lower (11.01 lower to 9.88 higher) |
– | 542 (4 RCTs) | ⨁⨁◯◯ LOW†‡§ |
*The risk in the intervention group (and its 95 % confidence interval [CI]) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
†Unclear risk of bias of randomization and allocation concealment.
‡Significant heterogeneity.
§Wide CI.
¶Small sample size and wide CI.
**High or unclear risk of attrition bias.
††Low events rate lead to imprecise estimation and small simple size.
‡‡ Number of patients progressed to ESKD were included in composite outcomes, not solely reported.
§§ Unclear risk of attrition bias and potential selecting report bias.
eGFR, estimated glomerular filtration rate; MD, mean difference; RR, risk ratio; Scr, serum creatinine; SMD, standardised mean difference.